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The Health Secretary has defended efforts to tackle a “weekend effect” in the NHS which means patients are more likely to die if they are admitted to hospitals outside regular hours.

Jeremy Hunt was quizzed by the Commons health select committee as the Government and British Medical Association (BMA) began the first day of fresh talks about a controversial new contract.

Both sides have agreed to take part in five days of “intensive talks” at Acas, following five strikes which have seen more than 150,000 operations and appointments cancelled.

In recent days, studies have questioned research showing that patients are more likely to die after being admitted to hospital at the weekend.

On Friday research by the University of Manchester said rates of deaths were only higher because patients admitted at the weekend were more likely to be sicker than those arriving at other times.

A number of critics said this suggested there was little evidence linking higher death rates to worse care at weekends.

But Mr Hunt said the study highlighted the Government’s concern that patients were less likely to receive care at weekends, and had to be sicker to be able to secure an admission.

“There is a weekend effect. Hospitals are applying a more stringent threshold to emergency admissions,” he told the Commons health select committee.

“We don’t offer the same standard of care at weekend,” he said, suggesting the same cases which would be admitted for care on a weekday would not be admitted on a Saturday or Sunday.

“They conclude that there is a weekend effect because you have to be more ill to be admitted,” Mr Hunt said.

Simon Stevens, head of the NHS said those planning services had to think about “the standard of care that we would want for our mum or daughter”.

The session came as doctors' leaders and the Government returned to the negotiating table in a bid to break the deadlock over the controversial contract for junior medics.

The move comes after Mr Hunt agreed to a five-day pause in the imposition of the new junior doctors' contract, with the BMA committing to hold off any decision on further strikes during the talks.

One of the main bones of contention was over whether Saturdays should attract extra "unsocial" payments.

The BMA has said any contract – agreed or not - should be put to a referendum of junior doctors.

At the Commons hearing, Mr Hunt and Mr Stevens said the NHS was making strenuous efforts to reduce spending on agency workers.

Paying rates of up to £3,500 a day for agency doctors has had a "poisonous" effect on other staff, Mr Hunt said, amid evidence that costs have reached £3.7bn in the last year.

Jeremy Hunt said the NHS was starting to "turn the tide" on "exploding" agency spending, but said costs had "mushroomed" as the health service attempted to respond to the Mid Staffs scandal, and improve its safety record.

The health secretary said there was evidence that some of the spending was beginning to "level off" with around £290m saved in agency costs in recent months.

"We are starting to turn the tide on the exploding agency bill," Mr Hunt told the Commons health select committee.

"We can see why it exploded, because the big issue was Mid Staffs," he said, suggesting that spending on agency workers instead of staff, had been an "unintended consequence" of understandable attempts to plug staffing gaps.

Mr Hunt said the high rates paid had created tensions with staff on the pay roll, and left patients suffering from a lack of continuity. "It's poisonous at ward level if you have a doctor being paid £3,500 a shift," he said, pointing out that much of the spending had gone to agencies.

But MPs questioned whether there were sufficient workers in place in some hospitals, criticising "arbitrary" demands on trusts to make efficiency savings, which they said were risking patient safety.

Paula Sherriff, MP for Dewsbury, described scenes from Mid Yorkshire Hospitals trust, where she said "it is absolutely clear that safety is being compromised" with half as many staff as required, and "tempers fraying on the wards".

The trust, runs Pinderfields Hospital in Wakefield, and hospitals in Pontefract and Dewsbury.

Mr Hunt said decisions should not be taken that meant patients were unsafe, promising to look into any specific concerns.

He said the NHS was making "heroic and wonderful" efforts to keep NHS patients safe, and said the service was facing a difficult "cocktail" of challenges, including rising demand from an ageing population and financial pressures.

At the health select committee hearing, Simon Stevens, head of the NHS admitted that spending on agency staff has "had a big spiral" - rising from £2.5bn to £3.7bn.

It came as MPs quizzed health officials on whether efforts to bring down the NHS deficit amount to little more than "clever accounting".

The questions from Dr Sarah Wollaston, head of the Commons health select committee, came after a series of experts suggested that changes to the accounts would give a "false" impression of the finances of the NHS.

David Williams, DoH director of finance told MPs on Monday that changes being required to accounts were "not just clever accounting" after Dr Wollaston questioned him on moves to defer capital to prop up revenue spending.

As the Commons hearing got underway, NHS Improvement published analysis showing that the NHS would have spent £4bn on agency staff, if efforts had not been made to cap rates, which took spending down to £3.7bn.

The analysis shows that the average price paid for a nursing shift has dropped by 10 per cent.

Jim Mackey, NHS Improvement Chief Executive, said: “We’ve known the scale of the financial challenge facing the NHS for sometime and dramatically reducing the amount of money hospitals spend on agency staff is a key part of our plan to balance the books.

Jeremy Hunt is being questioned today by MPs on the Comprehensive Spending Review and Social Care billCredit:
Neil Hall/PA Wire

“The measures have had a real impact and we are starting to see a significant reduction in the amount of NHS money being paid to these agencies. We need to keep up the pressure and make sure the era of overreliance on agency staff comes to an end.”

Health Secretary Jeremy Hunt said: "For too long rip off staffing agencies have been able to charge extortionate rates, but this data shows our controls are bearing fruit.

“This is good news for patients because the savings will be reinvested in frontline patient care and it will also lead to more staff coming back from agencies to permanent roles in the NHS, enabling hospitals to deliver better continuity of care.”